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Related Experiment Video

Updated: Jun 17, 2026

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
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[Unreamed intramedullary nailing].

R Attal1, M Blauth

  • 1Universitätsklinik für Unfallchirurgie und Sporttraumatologie, Medizinische Universität Innsbruck, Anichstr. 35, A-6020 Innsbruck, Osterreich. rene.attal@uki.at

Der Orthopade
|January 13, 2010
PubMed
Summary
This summary is machine-generated.

Reamed intramedullary nailing is recommended for isolated femur and tibia fractures based on recent evidence. Unreamed nailing shows higher non-union rates, while external fixators are safer for severe multiple injuries.

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Area of Science:

  • Orthopedics
  • Trauma Surgery
  • Biomedical Engineering

Background:

  • Intramedullary nailing for long bone fractures has seen debate regarding reaming vs. non-reaming techniques.
  • Historically, unreamed nailing was favored for its perceived biological advantages, particularly in open fractures.

Purpose of the Study:

  • To provide a historical overview of intramedullary nailing techniques.
  • To present current evidence on reamed versus unreamed intramedullary nailing for long bone fractures.

Main Methods:

  • Review of historical practices in intramedullary nailing.
  • Analysis of randomized controlled trials published since 2000 comparing reamed and unreamed nailing.

Main Results:

  • Randomized controlled trials since 2000 indicate unreamed nailing is associated with higher rates of delayed or non-union.
  • Evidence supporting improved vascularity or reduced infection rates with unreamed nailing is lacking.
  • External fixators are suggested for severe multiple injury settings due to adverse events with both nailing types.

Conclusions:

  • Evidence-based medicine supports reamed intramedullary nailing for isolated femur and tibia fractures.
  • Unreamed nailing is not superior and may increase non-union risks.
  • External fixation is a safer alternative for complex polytrauma involving long bone fractures.